Schoffl et al developed a grading scheme for injury to a finger's pulley mechanism. The authors are from Klinkkum Bamberg and Friedrich Alexander University of Erlangen-Nuremberg in Germany.
Location |
Pulley |
distal middle phalanx |
A1 |
middle of middle phalanx |
A2 |
proximal interphalangeal joint |
A3 |
middle of proximal phalanx |
A4 |
metacarpal to proximal phalangeal joint |
A5 |
Strain |
Partial Rupture |
Complete Rupture |
Grade |
none |
none |
none |
0 |
present |
none |
none |
I |
NA |
A2 or A3 |
none |
II |
NA |
NA |
A4 |
II |
NA |
NA |
A2 or A3 |
III |
NA |
NA |
A2 and A3 |
IV |
NA |
NA |
A2 and A3 and A4 |
IV |
NA |
NA |
A2 or A3 plus (muscle or ligament injury) |
IV |
where:
• Ligament = collateral ligament
• Muscle = musculi lumbricales manus
Specialty: Surgery, orthopedic